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Smoking cessation services

Smoking cessation services. Implementing NICE guidance. 2008. NICE public health guidance 10. Updated guidance.

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Smoking cessation services

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  1. Smoking cessation services Implementing NICE guidance 2008 NICE public health guidance 10

  2. Updated guidance • This guidance cross-references‘Brief interventions and referral for smoking cessation in primary care and other settings’‘Workplace interventions to promote smoking cessation’ ‘Varenicline for smoking cessation’ • This guidance replaces‘Guidance on the use of nicotine replacement therapy (NRT) and bupropion for smoking cessation’ (NICE technology appraisal guidance 39).It also addresses the NRT licensing authorisationfor particular groups

  3. What this presentation covers • Background • Key priorities for implementation • Costs and savings • Discussion • Where to find out more

  4. Background • Smoking causes 86,500 deaths a year in England • Smoking causes a wide range of diseases including cancers and coronary heart disease • Smoking is estimated to cost the NHS £1.5 billion a year • Smoking accounts for over half the difference in excess risk of premature death for men between social classes

  5. Smoking cessation services:strategic issues • Determine the characteristics and prevalence of tobacco use locallyEnsure NHS Stop Smoking Services: • target minority ethnic and socioeconomically disadvantaged communities • maintain adequate staffing levels, including a full-time coordinator • establish links with ante- and postnatal services

  6. Smoking cessation services:strategic issues NHS Stop Smoking Services should: • set realistic performance targets, reflectinglocal population demographics • routinely audit and publish performance data • aim to treat at least 5% of local tobacco users annually • aim for at least 35% success rate at 4 weeks

  7. Service delivery:effective interventions • Brief interventions • Individual/group behavioural therapy • Pharmacotherapies • Self-help materials • Telephone counselling and quitlines • Mass media

  8. Smoking cessation services:service delivery NHS Stop Smoking Services should: • offer behavioural counselling, group therapy,pharmacotherapy or a combination of proventreatments • ensure the number of clients treated fromminority ethnic and disadvantaged groups is at least in proportion to their representation inthe local population of tobacco users

  9. Smoking cessation services: service delivery NHS Stop Smoking Services should: • ensure staff providing behavioural support are trained and supervised in compliance with the ‘Standard for training in smoking cessation treatments’

  10. Pharmacotherapy • Offer pharmacotherapy in conjunction with advice and support; including a referral to the NHS Stop Smoking Service. • Offer NRT, varenicline or bupropion within an abstinent-contingent treatment • Explain the risks and benefits of NRT to young people aged 12-17 years, pregnant or breastfeeding women and people with unstable cardiovascular disorders • Offer the above groups behavioural support

  11. Pharmacotherapy • When determining which therapy to use consider: • if the client has been offered a referral to an NHS Stop Smoking Service • contra-indications • personal preferences • availability of counselling • likelihood of them completing the treatment • their previous experience of using a smoking cessation aid

  12. Pregnancy Professionals working with pregnant women should: • discuss, monitor and record their smoking status • encourage those who smoke to stop and to use NHS Stop Smoking Services or the NHS Pregnancy Smoking Helpline • offer smoking cessation support throughout the pregnancy and beyond • discuss the risks and benefits of NRT with those who smoke

  13. Costs and savings per 100,000 population

  14. Discussion • How can we provide accessible and responsive smoking cessation services for vulnerable and hard to reach groups?What can we do to encourage closer working between antenatal and NHS Stop Smoking Services?When should patients in secondary care be referred to NHS Stop Smoking Services?How can pharmacists, dentists and community health practitioners become more involved in smoking cessation work?

  15. Find out more • Visit www.nice.org.uk/PH010 for: • other guidance formats • costing report and template • audit support • algorithm of potential smoking cessation interventions during ante- and postnatal care • implementation advice

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